Drug therapy plays a key role in the therapy of chronic diseases1. However, its effectiveness is closely related to the patient's compliance with medical recommendations2, which in turn depends on many factors, including the patient's support for treatment and a trusted relationship with the doctor3.
In this article, you will learn how neurology doctors have used the Doctor.One platform for ongoing medical care of patients with multiple sclerosis (MS) to increase the effectiveness of therapy and improve the quality of care.
Drug therapy in MS and its limitations
The basis of the MS treatment process is long-term drug therapy. Taking medication regularly is essential to control symptoms and delay the progression of the disease4. However, the effectiveness of therapy decreases significantly in the case of low patient adherence4. According to research, one of the key factors negatively affecting adherence in MS therapy is the patient's lack of knowledge about the disease and the treatment process5. The reason for this is insufficient support from the attending physician (or nurse or care coordinator)6 and insufficient education7. Therefore, patient support programs7, educational programs, trusted and constant communication with the doctor (or care coordinator) - the patient prove most effective in maintaining patient adherence and the effectiveness of MS treatment4.
Major challenges for MS patients and treating physicians*
A patient with MS is in contact with his attending physician on average once every three months. This traditional model of care, which is based exclusively on remote in-patient visits, does not favor the maintenance of high adherence. In practice, this means that in the period between visits, patients are left without support, having numerous questions or complaints, the answers to which they seek on their own, often using unreliable sources of information. The treating physicians, on the other hand, lack safe and effective tools to remotely monitor patients' therapy, receive feedback on their health status, and a channel for communication and modification of the treatment process.
* Information comes from qualitative research conducted by Doctor.One
Coordination of care in the Doctor.One app
In response to these challenges, we created a pilot project involving 10 neurologist doctors and their MS patients, whose main goal was ongoing support and education in the disease and treatment through the Doctor.One app. With the app, patients can turn to the doctor with disturbing symptoms or questions about the disease and therapy. Doctors, on the other hand, gained space to monitor the treatment process remotely, as a complement to in-patient visits. The new process of coordinating care with the inclusion of the Doctor.One application consisted of 3 elements:
Invitation of patients
In the first phase of the project, the doctor invited 20 of his MS patients to join the platform, which made it possible to monitor the course of treatment on an ongoing basis and provide ongoing education.
Virtual Tour
The doctor booked in his calendar two windows a week (about 30 minutes) dedicated to the so-called virtual celebrations. During these sessions, he answered current questions and needs of patients and proactively monitored the effects of therapy. Thanks to the feedback, the doctor could also modify the treatment and, if necessary, decide on additional consultations (e.g. with a physiotherapist or psychologist).
Control visit
Regular, quarterly inpatient visits were used for diagnostic activities, e.g. to verify the patient's physical fitness. Further education and ongoing monitoring was carried out through the application at the celebrations.
Results of the pilot programme
The Doctor.One app pilot brought significant benefits for both patients and treating physicians. Patients reported higher satisfaction with care and a better understanding of their therapy and illness through more frequent micro-interactions with their doctor. Doctors, in turn, noted improvements in the effectiveness of therapy management and the quality of care, thanks to regular contact and the ability to respond quickly to the needs of patients.
The integration of modern communication technologies in the treatment of chronic diseases, such as multiple sclerosis, can significantly improve patients' adherence to medical recommendations. By focusing on the development of such solutions, we can raise the standards of medical care and its effectiveness in the management of chronic diseases.
- Rodis JL, Sevin A, Awad MH, et al. Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers. Journal of Primary Care & Community Health. 2017;8(4):324-331.
- Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011 Apr;86(4):304-14.
- Yao, S., Lix, L., Teare, G., Evans, C., & Blackburn, D. (2022). An integrated continuity of care measure improves performance in models predicting medication adherence using population-based administrative data. PloS one, 17(3), e0264170.
- Kołtuniuk A, Chojdak-Łukasiewicz J. Adherence to Therapy in Patients with Multiple Sclerosis—Review. International Journal of Environmental Research and Public Health. 2022; 19(4):2203.
- Erbay Ö, Usta Yeşilbalkan Ö, Yüceyar N. Factors Affecting the Adherence to Disease-Modifying Therapy in Patients With Multiple Sclerosis. J Neurosci Nurs. 2018 Oct;50(5):291-297.
- Washington F, Langdon D. Factors affecting adherence to disease-modifying therapies in multiple sclerosis: systematic review. J Neurol. 2022 Apr;269(4):1861-1872.
- Lenz F, Harms L. The Impact of Patient Support Programs on Adherence to Disease-Modifying Therapies of Patients with Relapsing-Remitting Multiple Sclerosis in Germany: A Non-Interventional, Prospective Study. Adv Ther. 2020 Jun;37(6):2999-3009.
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